Many approaches to combat the spread and impact of HIV/AIDS have failed to take gender differences and inequalities into account. Some have reaffirmed ideas of female passivity and male dominance in decisions on sex and reproduction. Others have responded to the different needs and constraints of women and men, but failed to challenge the gender status quo. This Overview Report analyses why and how HIV/AIDS is now disproportionately affecting women, as individuals and in their roles as mothers and carers. It explores new gender-sensitive approaches to fighting HIV/AIDS and suggests that in order to be effective, it is necessary to deal with the inequalities that both drive and are entrenched by the epidemic.

Recommendations from the Overview Report

Use a gendered human rights framework:

Various conventions and declarations provide useful frameworks for action which strongly emphasise sexual and reproductive rights along with broader social, economic and political rights. For instance, specific recommendations in the Barcelona Bill of Rights (see Supporting Resource Collection for a complete list of recommendations) include but are not limited to the right to:

Sexual and reproductive health services, including access to safe abortion without coercion.

Access user-friendly and affordable prevention technologies, such as female condoms and microbicides, with skills-building training on negotiation and use.

Choose to disclose their status in circumstances of safety and security without the threat of violence, discrimination or stigma.

HIV/AIDS policy and programmes must be informed by the complex and diverse lived realities of women, men and children:

The people most affected by any development issue must be an integral part of the process of defining the problem and finding solutions. Development initiatives should therefore start with their priorities.

Involve women and men living with HIV and those most vulnerable at all levels of policy, planning and programmes. This will probably involve building their capacity, including skills training, to do so (see the Supporting Resources Collection for a list of 12 statements from ICW on improving the situation of women living with HIV and AIDS throughout the world).

Acknowledge and do not stigmatise the sexuality of young people, women, men who have sex with men, lesbian, bisexual and trans-gendered people, older people, and people with disabilities.

Change or transform unequal power between men and women to create a context where women have equal power and both women and men are less vulnerable:

Recognise that although the empowerment of women is an important goal of HIV/AIDS interventions, the transformation of gender relations is needed before empowerment is fully realised.

Involve men in HIV/AIDS interventions that challenge the gender status quo because their involvement is crucial in transforming gender relations and because gender roles and expectations also put them at risk.

Ensure that interventions with men do not compromise women’s rights, reaffirm stereotypes, or replace working with women.

Develop a co-ordinated response to HIV/AIDS that is multi-levelled, multi-faceted and multi-sectoral and institutionalised:

Recognise that all sectors and development programmes need to take gender and HIV/AIDS into account and that there is no sector to which it is irrelevant

Although programmes may not have the resources to be multi-pronged, programmes need to support a co-ordinated response that is both empowering and transformatory.